title: 13C-aminopyrine demethylation is decreased in cirrhotic patients with normal biochemical markers.
abstract: This study determined the rates of (13)C-aminopyrine metabolism in patients with varying degrees of liver cirrhosis as defined by clinical scores. Twenty-five cirrhotic patients and 18 healthy subjects underwent a (13)C-aminopyrine breath test. The cumulative per cent dose recovery (cPDR) of (13)C on breath expressed as a percentage of the administered dose at 2 h was significantly lower in cirrhotic patients than in healthy subjects (median: 1.7% versus 9.0%; p<.0001). Significant inverse associations between cPDR at 2 h and the model for end-stage liver disease score, Child-Pugh score, international normalised ratio and bilirubin (all p<.05), but not alanine aminotransferase or alkaline phosphatase were observed in the cirrhotic patients. Taking each biochemical marker independently, cirrhotic patients with normal biochemistry had a significantly lower cPDR at 2 h than healthy subjects (all p<.05). Differences in (13)C-aminopyrine metabolism were evident in cirrhotic patients with less severe disease and may mark hepatic dysfunction when conventional biochemical markers appear unchanged.
authors.affiliation: a National Institute for Health Research Biomedical Research Centre (Nutrition), Southampton Centre for Biomedical Research, Southampton General Hospital , Southampton , UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Afolabi
authors.forename: Mark
authors.initials: M
authors.lastname: Wright
authors.forename: Steve A
authors.initials: SA
authors.lastname: Wootton
authors.forename: Alan A
authors.initials: AA
authors.lastname: Jackson
mesh_terms: D000328:Adult; D000632:Aminopyrine / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D001944:Breath Tests; D002247:Carbon Isotopes / Q000378:metabolism; D005260:Female; D005387:Finland; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000378:metabolism*; D008111:Liver Function Tests; D008297:Male; D008745:Methylation; D008875:Middle Aged; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002247:Carbon Isotopes; D000632:Aminopyrine